AB0785 Role of Patient Organizations in Implementation of Recommended Non-pharmacological Treatment Modalities in Spondyloarthritis: Evidence for the Effectiveness of Self-management Strategies
Authors: D. Meyer-Olson, K. Hoeper, L. Hammel, S. Lieb, A. Haehle, U. Kiltz
Journal: Annals of the Rheumatic Diseases (2022)

Background EULAR recommends participation in patient (pt) organizations to improve pt self-management of axial spondyloarthritis (axSpA) 1 . Non-pharmacological treatment modalities (NPTM) 2 are recommended in axSpA treatment guidelines. 3 Objectives To characterize the impact of pt advocacy group membership and its association with NPTM frequency and clinical parameters in axSpA. Methods Pts with a confirmed axSpA diagnosis were enrolled in the multicenter, observational ATTENTUS-axSpA survey conducted across Germany (11/2019–07/2020). Demographics, clinical and pt-related data were collected electronically. Results Of the 787 enrolled axSpA pts, this analysis was conducted on the working population (n=695) 4 . Overall, 12.2% (n=85) pts were members of a pt advocacy group and 87.8% (n=610) were not. Pt advocacy group members had higher Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores, increased functional impairment (BASFI, Bath Ankylosing Spondylitis Functional Index) and higher impact of axSpA on health (ASAS-HI, Assessment of SpondyloArthritis International Society-Health Index; Table 1). Despite worse prognostic factors, there was no significant difference in Work Productivity and Activity Impairment (WPAI) score [40.6 (27.0) for pt advocacy group members vs 36.8 (29.9) for non-members; p=0.380]. Membership in a pt advocacy group was associated with increased prescribed, supervised NPTM (57.6% [n=49] vs 34.4% [n=210]). Pts reported to have ever received 2.6 rehabilitation measures, and ≥3.0 different rehabilitation NPTM measures. Cumulatively, 25.0% (N=654) of rehabilitation measures were physiotherapy (Figure 1). Table 1. Descriptive characteristics and impact of membership in pt advocacy group Characteristic Patient advocacy group member (n=85) Not patient advocacy group member (n=610) Total (n=695) p-value Age (yrs), mean (SD) 50.2 (7.7) 44.6 (11.1) 45.3 (10.9) &lt;0.001 BMI (kg/m2) mean (SD) 27.5 (5.0) 28.0 (12.7) 28.0 (12.0) 0.713 Male, n (%) 45 (52.9) 378 (62.0) 423 (60.9) 0.128 Disease duration (yrs) mean (SD) 13.7 (10.3) 12.5 (11.1) 12.6 (11.0) 0.303 ASAS-HI, 0-17 7.3 (3.4) 6.4 (3.9) 6.5 (3.8) 0.045 BASDAI, 0-10 4.3 (1.9) 3.8 (2.2) 3.9 (2.2) 0.044 BASDAI ≥4, n (%) 49 (57.6) 275 (45.1) 324 (46.6) 0.025 BASFI, 0-10 3.9 (2.3) 3.2 (2.5) 3.3 (2.4) 0.015 Biologic treatment, n (%) 52 (61.2) 312 (51.1) 364 (52.4) 0.072 Full time employment, n (%) 48 (56.5) 410 (67.2) 458 (65.9) 0.06 Absenteeism*, mean (SD) 8.4 (21.2) 10.9 (26.8) 10.6 (26.2) - Presenteeism*, mean (SD) 38.4 (24.6) 31.8 (25.7) 32.6 (25.6) - Overall work impairment score*, mean (SD) 40.6 (27.0) 36.8 (29.9) 37.2 (29.6) 0.380 Activity impairment, mean (SD) 46.7 (21.7) 40.5 (26.8) 41.3 (26.4) 0.058 Pts having ever received medicinal rehabilitation measures, mean (SD) 67 (78.8) 328 (53.8) 395 (56.8) &lt;0.001 Prescribed supervised group NPTM # , mean (SD) 49 (57.6) 210 (34.4) 259 (37.3) &lt;0.001 Regular physical training † , mean (SD) 76 (89.4) 515 (84.4) 591 (85.0) 0.231 *Work-related questions of WPAI-score have been calculated for pts in employment (N=340); † regular physical training in the context of axSpA; # rehabilitation sport and/or functional training. ASAS-HI, Assessment of SpondyloArthritis International Society-Health Index; BASDAI, Bath Ankylosing Spondylitis Disease Activity Index; BASFI, Bath Ankylosing Spondylitis Functional Index; BMI, Body Mass Index; n, number of pts; pts, patients; SD, Standard Deviation; WPAI, Work Productivity and Activity Impairment; yrs, years. Conclusion Pt advocacy group membership was associated with increased prescribed NPTM in axSpA. Pt organizations may support the implementation of guidelines and improvement of self-management strategies in pts with axSpA, which may influence work participation. References [1]Nikiphorou E, et al. Ann Rheum Dis 2021;0:1–8 [2]Rausch Osthoff A-K, et al. Ann Rheum Dis 2018;77:1251–1260 [3]van der Heijde D, et al. Ann Rheum Dis 2017;76:978–991 [4]Kiltz et al. 2021. EULAR eposter; POS0983 Disclosure of Interests Dirk Meyer-Olson Speakers bureau: Speakers bureau: Abbvie, Amgen,Berlin Chemie, Bristol Myers Squibb, Cellgene, Chugai, Fresenius Kabi, GSK, Jansen Cilag, Lilly, Medac, Merck Sharp &amp; Dome, Mylan, Novartis, Pfizer, Sandoz Hexal, Sanofi and UCB, Consultant of:Abbvie, Amgen, Berlin Chemie, Bristol Myers Squibb, Cellgene, Chugai, Fresenius Kabi, GSK, Jansen Cilag, Lilly, Medac, Merck Sharp &amp; Dome, Mylan, Novartis, Pfizer, Sandoz Hexal, Sanofi and UCB, Kirsten Hoeper Speakers bureau: Speakers bureau: Abbvie, Chugai, Gilead, Lilly, Novartis, Sandoz Hexal and Sanofi., Consultant of: Abbvie, Chugai, Gilead, Lilly, Novartis, Sandoz Hexal and Sanofi., Ludwig Hammel: None declared, Sebastian Lieb Employee of: Employee of Novartis, Andreas Haehle Employee of: Employee of Novartis, Uta Kiltz Speakers bureau: Speakers bureau: AbbVie, Biocad, Chugai, Eli Lilly, Grünenthal, Janssen, MSD, Novartis, Pfizer, Roche and UCB, Consultant of: AbbVie, Biocad, Chugai, Eli Lilly, Grünenthal, Janssen, MSD, Novartis, Pfizer, Roche and UCB, Grant/research support from: Abbvie, Amgen, Biogen, Fresenius, GSK, Novartis and Pfizer